Prescription Pad LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

36033RP Issued in ID

Legal business name

PRESCRIPTION PAD LLC

Doing business as

The Prescription Pad

Practice address

1620 N Whitley Dr
Fruitland, ID 83619-2129

Phone

(208) 452-7075

Fax

(208) 452-7446

NPI assigned

Jul 14, 2014

Last updated

Apr 12, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Trenton John Jenks, PHARMD, BCGPNPI 1821218553

Title

Owner

Phone

(208) 452-7075

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• The Prescription Pad Doing business as

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Prescription Pad LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prescription Pad LLC

  • Community/Retail Pharmacy
  • Meridian, ID
  • NPI 1073133328
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Prescription Pad LLC

  • Community/Retail Pharmacy
  • Meridian, ID
  • NPI 1073133328
  NPPES parent name

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Trenton John Jenks, PHARM. D, CGP

  • Pharmacist
  • Fruitland, ID
  • NPI 1821218553
  NPD Authorized official
• Kyle Daron, PHARMD

  • Pharmacist
  • Fruitland, ID
  • NPI 1548004930
  NPD
• Erin Doraine Jackson, PHARMD, CDM

  • Pharmacist
  • Fruitland, ID
  • NPI 1447448154
  NPD
• Janette Kameshige, RPH

  • Pharmacist
  • Fruitland, ID
  • NPI 1174128573
  NPD
• Judd Alan Knudsen, RPH

  • Pharmacist
  • Fruitland, ID
  • NPI 1104112903
  NPD
• Alexandria Monique Landaverde, PHARM D.

  • Pharmacist
  • Fruitland, ID
  • NPI 1205409158
  NPD
• Brooke Hally, PHARMD

  • Pharmacist
  • Ontario, OR
  • NPI 1760866032
  NPD (past)
• Jennifer King, FNP-BC

  • Family Nurse Practitioner
  • Ontario, OR
  • NPI 1477958494
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1891102653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192129",
            "telephone_number": "208-452-7075",
            "fax_number": "208-452-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 N WHITLEY DR",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192129",
            "telephone_number": "208-452-7075",
            "fax_number": "208-452-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCRIPTION PAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "JENKS",
        "authorized_official_first_name": "TRENTON",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-452-7075",
        "authorized_official_credential": "PHARMD, BCGP"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "0002947",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "36033RP",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891102653",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147081",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Prescription Pad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Prescription Pad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Anne Pace, NP
• Caleb Patee, D.O.
• Payette School Dist #373
• Sharla J Phelps, LMSW
• Kelley A Phipps
• McKenzie Pulsipher, DPT
• Jeanette Hazel Marie Reiners, DNP, FNP
• Jeanna Rae Rendo, NP-C
• RH Counseling and Therapy LLC
• Sierra Marie Riley

• Community/Retail Pharmacy in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.